Participant Waiver And Release Of Liability Sample Waiver Form For Minors (Under Age 18) printable pdf download

PARTICIPANT WAIVER AND RELEASE OF LIABILITY,

ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

Sample

Waiver Form for MINORS (Under Age 18)

Event Name/Activity Description: __________________________________________________________________________________

Event/Activity Date(s): _______________________________________________________________________________________________

Event/Activity Location:

_________________________________________________________________________________________

(“Coach”) allowing the minor identified below (“Minor”) to participate in the event

For and in consideration of

[Insert Name of Instructor/Coach]

or activity described above (the “Event” or “Events”); I, for myself, and on behalf of Minor, and the Minor’s parents/legal guardians, heirs and

next of kin, and any legal and personal representatives, executors, administrators, successors and assigns, hereby agree to and make the

following contractual representations pursuant to this Waiver and Release of Liability, Assumption of Risk and Indemnity Agreement (the

“Agreement”);

1. I hereby represent that (i) I am the parent or legal guardian of the Minor; (ii) the Minor is in good health and in proper physical condition to

participate in the Event; and (iii) the Minor is not under the influence of alcohol or any illicit or prescription drugs which would in any way

impair the Minor’s ability to safely participate in the Event, and that I am responsible for the Minor’s safety and well being at all times and

under all circumstances while at the Event.

2. I understand and acknowledge the risks and dangers associated with the Minor’s participation in the Event and the sport of water skiing

and related water sport disciplines, including without limitation, the potential for serious bodily injury, sickness and disease, permanent

disability, paralysis and loss of life; loss of or damage to equipment/property; exposure to extreme conditions and circumstances; contact

with other participants, spectators, boats, animals or other natural or manmade objects; dangers arising from adverse weather conditions;

imperfect ski course conditions; water and surface hazards; equipment failure; inadequate safety measures; participants of varying skill

levels; situations beyond the immediate control of the Event Organizers; and other undefined, not readily foreseeable and presently

unknown risks and dangers (“Risks”). I understand that these Risks may be caused in whole or in part by the Minor’s own actions or

inactions, the actions or inactions of others participating in the Event, or the negligent acts or omissions of the Released Parties defined

below, and on behalf of the Minor, I hereby expressly assume all such Risks and responsibility for any damages, liabilities, losses or

expenses which I incur as a result of the Minor’s participation in any Event.

3. I understand that the Minor is required to be familiar with and to abide by the Rules and Regulations established for the benefit and safety

of all participants in the Event. I accept sole responsibility for the conduct and actions of the Minor while he or she is participating in the

Event, and the condition and adequacy of the Minor’s equipment. I understand that the Event Organizers have the right to disqualify

anyone or deny participation in the Event for any reason they deem just and proper in their sole discretion.

4. On behalf of the Minor, I hereby Release, Waive and Covenant Not to Sue, and further agree to Indemnify, Defend and Hold Harmless the

(Individually and Collectively, the “Released Parties” or

following parties:

[Insert Name of Coach and other parties to be Released]

“Event Organizers”), with respect to any liability, claim(s), demand(s), cause(s) of action, damage(s), loss or expense (including court

costs and reasonable attorneys fees) of any kind or nature (“Liability”) which may arise out of, result from, or relate in any way to the

Minor’s participation in the Event, including claims for Liability caused in whole or in part by the negligent acts or omissions of the Released

Parties. I further agree that if, despite this Agreement, the Minor, or anyone on the Minor’s behalf, makes a claim for Liability against any of

the Released Parties, I will indemnify, defend and hold harmless each of the Released Parties from any such Liabilities which any may be

incurred as the result of such claim.

I hereby warrant that I am of legal age and authorized to enter into this Agreement on behalf of the Minor, that I have read this Agreement

carefully, understand its terms and conditions, acknowledge that I will be giving up substantial legal rights by signing it (including the rights of

the Minor, the Minor’s parents/legal guardians, heirs and next of kin, and any legal and personal representatives, executors, administrators,

successors and assigns), acknowledge that I have signed this Agreement without any inducement, assurance or guarantee, and intend for my

signature to serve as confirmation of my complete and unconditional acceptance of the terms, conditions and provisions of this Agreement. This

Agreement represents the complete understanding between the parties regarding these issues and no oral representations, statements or

inducements have been made apart from this Agreement. If any provision of this Agreement is held to be unlawful, void, or for any reason

unenforceable, then that provision shall be deemed severable from this Agreement and shall not affect the validity and enforceability of any

remaining provisions.

Name of Minor: _________________________________________ Age: ______ Date of Birth: ______

______

_______

 Male  Female

X _____________________________________________________

_______/_______/____________

Signature of Parent/Legal Guardian for Minor(s)

Date Signed

Revised 1/01/2011

Participant Waiver And Release Of Liability Sample Waiver Form For Minors (Under Age 18)

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